Cargando…
Delayed Diagnosis of Giant Cell Arteritis in the Setting of Isolated Lingual Necrosis
BACKGROUND: Lingual necrosis is a rare complication of giant cell arteritis (GCA). METHODS: A 77-year-old woman presented for treatment of a painful and discolored tongue, odynophagia, and dehydration refractory to antimicrobials over 2 weeks. An extensive, well-demarcated necrotic area was visualiz...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587389/ https://www.ncbi.nlm.nih.gov/pubmed/31258343 http://dx.doi.org/10.1177/1179547619857690 |
_version_ | 1783429058578612224 |
---|---|
author | DeBord, Logan Christopher Chiu, Ilene Liou, Nelson Eddie |
author_facet | DeBord, Logan Christopher Chiu, Ilene Liou, Nelson Eddie |
author_sort | DeBord, Logan Christopher |
collection | PubMed |
description | BACKGROUND: Lingual necrosis is a rare complication of giant cell arteritis (GCA). METHODS: A 77-year-old woman presented for treatment of a painful and discolored tongue, odynophagia, and dehydration refractory to antimicrobials over 2 weeks. An extensive, well-demarcated necrotic area was visualized on the anterior tongue upon admission. Leukocytosis, thrombocytosis, and elevated erythrocyte sedimentation rate were present. Computed tomography angiogram of the head and neck revealed an undulated-beaded appearance of the distal internal carotid arteries and vertebral arteries bilaterally. RESULTS: High-dose intravenous steroids were initiated for suspected vasculitis. Temporal artery biopsy confirmed the diagnosis of GCA. The patient’s condition improved and the anterior tongue was well healed at 1 month follow-up. CONCLUSIONS: An atypical presentation of GCA (eg, isolated lingual necrosis) risks a delay in diagnosis and increased morbidity. Any patient above the age of 50 years presenting with tongue necrosis, in the absence of known cause, should undergo expedited workup for GCA. |
format | Online Article Text |
id | pubmed-6587389 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-65873892019-06-28 Delayed Diagnosis of Giant Cell Arteritis in the Setting of Isolated Lingual Necrosis DeBord, Logan Christopher Chiu, Ilene Liou, Nelson Eddie Clin Med Insights Case Rep Case Report BACKGROUND: Lingual necrosis is a rare complication of giant cell arteritis (GCA). METHODS: A 77-year-old woman presented for treatment of a painful and discolored tongue, odynophagia, and dehydration refractory to antimicrobials over 2 weeks. An extensive, well-demarcated necrotic area was visualized on the anterior tongue upon admission. Leukocytosis, thrombocytosis, and elevated erythrocyte sedimentation rate were present. Computed tomography angiogram of the head and neck revealed an undulated-beaded appearance of the distal internal carotid arteries and vertebral arteries bilaterally. RESULTS: High-dose intravenous steroids were initiated for suspected vasculitis. Temporal artery biopsy confirmed the diagnosis of GCA. The patient’s condition improved and the anterior tongue was well healed at 1 month follow-up. CONCLUSIONS: An atypical presentation of GCA (eg, isolated lingual necrosis) risks a delay in diagnosis and increased morbidity. Any patient above the age of 50 years presenting with tongue necrosis, in the absence of known cause, should undergo expedited workup for GCA. SAGE Publications 2019-06-20 /pmc/articles/PMC6587389/ /pubmed/31258343 http://dx.doi.org/10.1177/1179547619857690 Text en © The Author(s) 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Case Report DeBord, Logan Christopher Chiu, Ilene Liou, Nelson Eddie Delayed Diagnosis of Giant Cell Arteritis in the Setting of Isolated Lingual Necrosis |
title | Delayed Diagnosis of Giant Cell Arteritis in the Setting of Isolated Lingual Necrosis |
title_full | Delayed Diagnosis of Giant Cell Arteritis in the Setting of Isolated Lingual Necrosis |
title_fullStr | Delayed Diagnosis of Giant Cell Arteritis in the Setting of Isolated Lingual Necrosis |
title_full_unstemmed | Delayed Diagnosis of Giant Cell Arteritis in the Setting of Isolated Lingual Necrosis |
title_short | Delayed Diagnosis of Giant Cell Arteritis in the Setting of Isolated Lingual Necrosis |
title_sort | delayed diagnosis of giant cell arteritis in the setting of isolated lingual necrosis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587389/ https://www.ncbi.nlm.nih.gov/pubmed/31258343 http://dx.doi.org/10.1177/1179547619857690 |
work_keys_str_mv | AT debordloganchristopher delayeddiagnosisofgiantcellarteritisinthesettingofisolatedlingualnecrosis AT chiuilene delayeddiagnosisofgiantcellarteritisinthesettingofisolatedlingualnecrosis AT liounelsoneddie delayeddiagnosisofgiantcellarteritisinthesettingofisolatedlingualnecrosis |